[Estimated reading time: 17 minutes]

People…I have HPV. And I’m in good company, because up to 90% of us will be infected with at least one genital type of HPV at some time in our lives. But HPV is also the cause of nearly all cervical, anal, penile, vaginal, vulvar, and oropharangyal cancers. Admittedly, most cases of HPV won’t even result in symptoms and are completely harmless. But mine wasn’t.

HPV and STIs in general aren’t things we talk about a whole lot. And when things don’t get talked about openly, they tend to attract myths and misinformation. Like many people, I was under the impression that HPV was something that could only be contracted through unprotected sex. I also used to, like many people, confuse it with herpes (HSV) all the damn time. This is such a common mistake that there are hundreds of educational websites dedicated to teaching you the difference.

I’ve been in an open relationship for most of my adult life, and one of the rules my partner and I follow is to always use protection. Neither of us has ever broken this rule. However...both of us have engaged in unprotected sexual activity.

See, here’s the key thing, when people talk about condoms and dams preventing STIs, they’re right. But what most of us don’t realise is, you have to use them for absolutely all physical contact. Because if there is any genital to genital contact without a barrier in place AT ALL, that’s enough for you to contract HPV. This goes for oral and anal, and anything else you can think of.

And even though HPV is transmitted via skin-to-skin contact (as opposed to fluids) it can be contracted from sharing sex toys.

You don’t just have to have protected sex, you have to have protected sexual activity.

Basically, there has to be something in place, at all times, stopping either of your potential infection sites (genitals, anus and mouth) from touching. If it sounds like you need to wrap yourselves in glad wrap before getting down to sexy times, I’m not going to kink shame that.

What exactly is the cervix?

I know. We all had high school biology, we all know what the cervix is. It’s that weird woovy part after the vagina, but before the uterus, right?

But how familiar are you with your cervix?

Did you know that some forms of contraception prevent pregnancy by changing your cervical mucous?

Did you know that you can measure the changes to your cervix throughout your cycle to help you figure out the best time to conceive?

Did you know that it looks like a squishy pink donut?

Have you ever looked at photos of the cervix at different stages of the menstrual cycle?

Your cervix might look like a chubby kid’s belly button, but it’s actually a crucial part of your reproductive health system.

But, like Uncle Larry’s indoor hot tub it’s a wet, warm enclosed environment, which means that like the hot tub it’s prone to STIs.
Which is why it’s so important to stay on top of testing.

The Pap Smear & Cervical Screen

Now, I’m not a brave woman. When it comes to matters of blood and gore, I’ve had to ask other people to put band-aids on my paper cuts.

It’s not that I don’t have a great pain threshold, it’s that I am very easily terrified by any of the things that belong ‘inside’ my body ending up on the outside, or worse, anything going wrong with the bits inside me. And this is why I’ve always struggled to be pro-active about my cervical health.

Most cervix owners have spent their lives being told to get regular ‘pap smears’. Aside from the decidedly gross name, it’s not a super enjoyable procedure. I can still remember my first one. I felt like such a grown up. Here I was, sexually active, asking a nice lady doctor to swipe a Q-tip on my inside parts. What more does a girl dream of when growing up? She asked me to take off my jeans and knickers and lie down with my legs splayed out to either side. Then she asked me to sit on my hands, which I found super weird and assumed she was worried I would reach out and try to push her head down like my partner did whenever his pants were off. Turns out it helps tilt the pelvis up so it’s easier to see the cervix. She then showed me the speculum. If you’ve never seen a speculum, it looks kind of like a duck’s bill and opens and closes a bit like one. I make this comparison because my doctor said “Looks like a duck!” and then made it quack...right before she covered it in lube and put it inside my vagina. I felt like she was making me her muppet. Which honestly was preferable to what happened next.

My doctor had shown me the swab that she would be using to collect the sample, and from where I was sitting it looked kind of like a cotton tip, y’know those things you’re not meant to clean your ears with but totally do because it’s kind of like a tiny orgasm in your ear (an eargasm?). Turns out it’s more like a tiny toilet brush. So when it started scrubbing against my cervix, I was not anticipating the sensation. I mean, aside from anything else, my cervix had never really been touched before. But it felt like someone was trying to poke something out of my from inside my belly button. It was the most deeply uncomfortable sensation I’ve ever come across. It didn’t exactly hurt, it just felt seriously wrong. And for hours after it was over whenever I thought about it I involuntarily crossed my legs, bent over and just made various “blergh” noises.

The second time I had a pap smear, I told the doctor I was feeling light headed. She told me it would pass, and ushered me out to pay at reception. I passed out at the front desk and woke up in a recovery room with a stranger who informed me she’d been left there to watch me and then insisted on showing me photos of her pet bunnies for 45 minutes...I fucking hate bunnies.

So when Australia replaced the ‘pap smear’ with the ‘cervical screen’ I was hugely relieved. Not only because it’s a less gross thing to say, but also because the cervical screen is more effective than that pap smear it only needs to be done half as often. The problem with a more effective screening tool though - it’s more likely to pick up on anything bad lurking in your cervix. So when I got the call from my GP telling me I had abnormal cells, I was shook.

How did I get HPV? What was that vaccine for?

I couldn’t figure out what I’d done that could have exposed me to HPV. I always had protected sex, and I always made sure my sexual partners were up to date on their STI checks.

But here’s the thing, standard STI testing for penis owners doesn’t actually check for HPV. This is despite the fact that recent studies have shown nearly half of all men have genital HPV. And yet men are not tested for it and they’re not vaccinated against it (which is doubly problematic when you consider that many men still die from throat cancer caused by HPV).

In case you’re wondering, the standard asymptomatic STI screening practice in Australia only recommends testing for HIV, chlamydia, syphilis, hep B and gonorrhoea (and gonorrhoea is only recommended for at risk populations).

So if you end up with anything asymptomatic outside of the Big Five, chances are you’ll have no idea if you’re passing it on or not.

Once I realised that any unprotected sexual contact was enough for a transmission to occur, I realised that almost everything I’d ever done would have been enough for me to have contracted it. Every sexual action that wasn’t conducted through a barrier suddenly loomed large in my mind.

What then bamboozled me was how this had happened if I’d had all of my Gardasil shots. Wasn’t that the point of a vaccine? If it didn’t protect me against HPV and it didn’t give me autism, what was it good for?!

Well, it turns out that when I got my vaccinations, Gardasil only covered 4 strains of the virus (HPV types 6, 11, 16 and 18).

To be fair, 2 of those strains cause around 70% of cervical cancers and most of the other HPV related cancers, and the other 2 strains cause around 90% of genital warts cases - so it’s not nothing. But even though the new vaccine now covers 9 strains of the virus there are over 200 strains of HPV out there, so it’s not impossible to contract it even if you are vaccinated.

What do I do about the HPV?

Because the new cervical screen test is much more thorough than the old pap smear, the first thing that usually happens after your doctor tells you they’ve found abnormal cells, is that you wait.

If you had normal test results, you’d only need to have a cervical screening test once every five years. But if something suspicious shows up they’ll test you again in 12 months to see if your body has cleared the virus on its own.

So if you get an abnormal test result, you just need to chill for a year and hope that your body takes care of it. And in the vast majority of cases, that’s exactly what happens. You go back for your follow up and your doctor will let you know that there’s nothing suss on your cervix. Yay!

What if my body doesn’t clear the virus?

If after a year, your test results come back and say “Hey, your inside donut still has some danger sprinkles” I’m afraid you’re in for a colposcopy.

Currently the word ‘colposcopy’ is uncommon enough that most people think you mean a ‘colonoscopy’ which is where they stick a camera up your butt to check for cancer (which you should also do regularly if you have any cause to believe you might be at risk of bowel cancer). But I suspect in the next 5 years, in Australia at least, we’re gonna get a whole lot more familiar with colposcopies.

A colposcopy is usually done by an Obstetrician/Gynaecologist, but you can also have them done at a public hospital, or by a proceduralist centre. I went to a Gynae, because I’m already paying a fortune for my health insurance to cover my psych treatment, so why not make that shit work a little harder for its premium?

But what IS a colposcopy?

Have you ever been to the optometrist to have your eyes checked? You know that part before they test your ability to decide between two equally fuzzy pictures of letters (1...or 2...1...or 2, I don’t know Janet they both look the fucking same!), the part where they have that giant scope thing that looks beyond your eyeballs and into your very soul? Okay, so a colposcopy is like that, but instead of looking into your eyeballs, they’re looking into your cervix. Deep into your cervix.

The goal is to check for the same abnormal cells that showed up on your cervical screen and to take a small sample of them (a biopsy) to send away to pathology. This all sounds simple enough if you’re a hardened uterus owner who can handle their shit. It turns out though, I am not one of those. I sweat my way through just the cervical screen, for me this was some next level shit.

For a start, I’d never been up in stirrups before - that part was fine. Pretty comfortable actually, like those ergonomic office chairs from the 90s. But as soon as the speculum went in I started breathing like I was getting paid $5 for every inhalation.

Just when I was starting to calm down and my body was prepared to consider that maybe this wasn’t the most traumatic experience it had ever had, my gynae looked up and said “Great, so I’m just about to finish up here. I’ll grab a small sample and then you’re done!”

My brain is like “Cool, cool, nearly done, cool, cool.” And the next thing I knew my partner was standing next to me fanning my face saying “I think she’s coming back now.”

I’m not actually sure at what point I passed out, but apparently my partner thought I’d just up and died. My eyes had rolled back into my skull, my face went completely slack and my partner looked to the gynae for support and realised she was still elbow deep inside me and couldn’t really do much.

Thankfully, my gynae is a very lovely and non-judgemental person. So she told me that I’d been a great patient and to just take my time gathering myself, before going back to her room next door to discuss next steps. And as soon as she’d closed the door behind her I just burst into tears, legs still spread-eagle in the stirrups. Definitely one of my classier crying sessions. Thankfully my partner was there to help me put my knickers back on and try and gather what little shreds of dignity I had left.

After I made it safely back to the gynae’s office, still sniffling, she explained that she would likely have the test results back in less than a week and would give me a call with the results. She reassured me that it would most likely be some benign cells that we would just have to wait for my body to clear.

A few days later she called to let me know that my cervix was currently housing some pre-cancerous cells and that they would need to be evicted - by lasers.

What to expect after your colposcopy

Because my body needed to heal fully from the colposcopy before I had the follow up procedure to remove the abnormal cells, I had about a month of recovery before round 2. Now, obviously every body is very different, and my experience is certainly not the benchmark by which to set your expectations. But here are a few things to potentially keep in mind.

Expect some weird discharge. You know how if you make a cup-a-soup and then you forget about it for too long and come back to it and it has that weird skin over the surface? Imagine that, but it’s the colour of iodine. It doesn’t last too long, but it’s definitely on the gross-fascinating matrix the first time you encounter it.

I also experienced pain for quite a while. Not an all-the-time, debilitating pain. But if I sat cross-legged and leant forward for something, it felt like a particularly large dick was poking me in the cervix and demanding to know if I was going to cum or not. I also had sporadic spasms of pain, kind of like period cramps but a bit sharper and shorter - these lasted almost the whole month of recovery.

None of the pain was intolerable, but I did reach out to a few friends who had also had to procedure to check that it was normal and expected. They confirmed that, unfortunately, yes it was. Yay for cervical healthcare!

What to expect from your LLETZ/LEEP

You’ve probably never come across the term LLETZ or LEEP before. I know I hadn’t. I assumed it was some kind of internet jargon for people who posted the wrong gifs on 4chan. Turns out they’re more or less interchangeable terms for the same procedure, which involves running an electrified wire across the surface of your cervix to remove the surfaces that house the abnormal cells. Apparently this procedure is often performed with just a local anaesthetic applied to the cervix, and the patient remains awake the whole time.

Thankfully my gynae, obviously still traumatised by my histrionics at the colposcopy, performed mine under sedation. This meant that I got to rock up to the Epworth Hospital, change into a sexy assless gown, exchange some banter with the anaesthetist and then I was off to sleep for the next 20 - 30 minutes.

When I woke up some lovely nurses fed me tea and biscuits until I could string a coherent sentence together and I went home. But the best part was that at some point during the procedure they pumped me full of some 24 hour painkillers and anti-inflammation medication, so I didn’t even need to take a Panadol after it was done. I had absolutely zero pain.

What to expect after your LLETZ

After your LLETZ you can not have sex, use tampons, or insert anything into your vagina for about a month afterwards. This is to reduce the risk of infection, and also to give your cervix time to heal. Do not ignore these instructions, because if you do you can dislodge the scab that has formed over the wound on your cervix. This can then necessitate a trip to your gynae so that they can pack the wound with a clotting agent. Unpleasant.

One of the instructions you’ll receive whenever you have any kind of procedure relating to your vagina, cervix or uterus, is to keep an eye out for possible infection.

Signs of infection include fever, pain and flu-like symptoms. But one of the main signs of infection is smelly discharge. I promise that you will spend at least 20 seconds, sniffing the air around your crotch and pondering just how smelly is ‘smelly’. Because your vag will send forth some unique odours while your cervix recovers.

It starts with the soup skin, which by now you’re used to. But you’ll then get some ‘brown watery discharge’ for between a few days and a few weeks. Some people get clear watery discharge that has a strong umami odour. Some people get spotting. Some get bleeding.

Or maybe, like me, you’ll be one of the rare cases who gets small chunks of charcoal.

About 2 weeks after the procedure, I started to notice a kind of burned, smokey smell coming out of my vag. However, this coincided almost perfectly with the worst bushfires in Australian history, and smoke pollution from those fires covering most major cities and drastically affecting air quality. I assumed that since I’d been inhaling the equivalent of 20 packs a day for the last 48 hours, that this was just a particularly dire side effect.

Then the charcoal appeared. A little smudge of black on the toilet paper at first. Then some more noticeable flecks. Then it got to the point where there were enough small clots of it every time I wiped that I could have produced a charcoal drawing of my pussy and won myself a feminist art prize.

Every time I dropped my pants I had a faint whiff of a small brushfire in the distance. Whenever I went to the toilet I worried that I might actually be miscarrying the antichrist.

I wasn’t panicked by any of this, since to me it made sense. They had burned off chunks of my cervix with a hot wire, of course there were some burned crispy bits making their way out through the only available exit. But what began to bother me was when the clear-ish discharge I’d been told to expect started to mingle with the charcoal and suddenly I was finding my pad soaked with what looked, and kind of smelled like, satan’s semen.

It wasn’t infection level smelly, it didn’t want to make me want to gag. It was more like someone had turned the ‘generic pussy smell’ up to 11. Every time I uncrossed my legs it felt like it was wafting out of me, like I suddenly had Pepe Le Pew pussy (minus the sexual assault).

Thankfully all of the discharge and smell was gone a few weeks after the procedure. But it did make me realise there’s a market for smell-proof pads.

What happens now?

I’m now fully recovered from my LLETZ procedure. Which is handy, because the standard follow up for cases like mine means that I’ll be heading back for another cervical screen, and possibly another colposcopy, in about 6 months. Because I didn’t have quite enough fun the first time around.

Now, it’s pretty easy at this point to feel like the takeaway from all of this is that cervical health is a fucking horrific experience and to be avoided at all costs. But that’s not actually what I’m getting at. There is every chance that these abnormal cells could have been hanging around in my cervix for years, but were only picked up thanks to the new cervical screening process. If this had happened to me 20 years ago, it might not have been picked up until it was too late. And yes, the colposcopy was deeply unpleasant and having a brushfire in my bush was less than ideal - but I would (and will) do it all again happily. Okay, well slightly begrudgingly, but you get the point.

After losing far too many people in my life to cancer, I am infinitely grateful to live in a time when I can be tested and treated before I even get cancer. So if you’re putting off your regular testing, whether it’s cervical screens, colonoscopies, or just getting that lump checked out - please follow it up. I know how scary it can be. I know how uncomfortable it can be. But take advantage of the science we have available to us - get tested, get vaccinated. The world is a much nicer place with you in it - let’s keep it that way.

That is all.

You may go now.

HPV: A Public Cervix Announcement